Healthcare Provider Details

I. General information

NPI: 1083568489
Provider Name (Legal Business Name): JENNA DAWSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNA AUEL

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 US-412
SILOAM SPRINGS AR
72761
US

IV. Provider business mailing address

844 VIA SELVA AVE APT C
TONTITOWN AR
72762-4358
US

V. Phone/Fax

Practice location:
  • Phone: 479-373-1113
  • Fax:
Mailing address:
  • Phone: 903-949-7208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA2507017
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: